Alkaline phosphatase predicts relapse in chronic hepatitis C patients with end-of-treatment response

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:hongyin_wangyi
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AIM: To investigate relapse predictors in chronic hepatitis C (CHC) patients with end-of-treatment response (ETR), after pegylated interferon-α (PegIFN-α) and ribavirin treatment. METHODS: In a retrospective study we evaluated a spectrum of predictors of relapse after PegIFN-α and ribavirin treatment in 86 CHC patients with ETR. Viral loads were determined with real-time reverse transcrip-tion polymerase chain reaction. Hepatitis C virus geno-typing was performed by sequencing analysis. Patients with genotype 1 were treated for 48 wk with 180 μg PegIFN-α2a or 1.5 μg/kg PegIFN-α2b once weekly plus ribavirin at a dosage of 1000 mg/d for those under 75 kg or 1200 mg/d for those over 75 kg. Patients with geno- types 2 and 3 were treated for 24 wk with 180 μgPegIFN-α2a or 1.5 μg/kg PegIFN-α2b once weekly plus ribavirin at a dosage of 800 mg/d. RESULTS: In all ETR patients, binary logistic regression analysis identif ied absence of complete early virological response (cEVR) (OR 27.07, 95% CI: 3.09-237.26, P < 0.005), serum alkaline phosphatase (ALP) levels prior to therapy < 75 U/L (OR: 6.16, 95% CI: 2.1-18.03, P < 0.001) and body mass index > 26 kg/m2 (OR: 8.27, 95% CI: 2.22-30.84, P < 0.005) as independent predictors of relapse. When cEVR patients were analyzed exclusively, ALP prior to therapy < 75 U/L remained the only predictor of relapse. CONCLUSION: Lower levels of ALP prior to, during and after therapy seem to be associated with a higher risk of relapse in CHC patients with ETR. AIM: To investigate relapse predictors in chronic hepatitis C (CHC) patients with end-of-treatment response (ETR), after pegylated interferon-α (PegIFN-α) and ribavirin treatment. METHODS: In a retrospective study we evaluated a spectrum of predictors of relapse after PegIFN-α and ribavirin treatment in 86 CHC patients with ETR. Viral loads were determined with real-time reverse transcrip- tion polymerase chain reaction. Hepatitis C virus geno-typing was performed by sequencing analysis. treated for 48 wk with 180 μg PegIFN-α2a or 1.5 μg / kg PegIFN-α2b once weekly plus ribavirin at a dosage of 1000 mg / d for those under 75 kg or 1200 mg / d for those over 75 kg. Patients with geno- types 2 and 3 were treated for 24 wk with 180 μg PegIFN-α2a or 1.5 μg / kg PegIFN-α2b once weekly plus ribavirin at a dosage of 800 mg / d. RESULTS: In all ETR patients, binary logistic regression analysis identified absence of complete early virological response (cEVR) (OR 27 , Serum alkaline phosphatase (ALP) levels prior to therapy <75 U / L (OR: 6.16, 95% CI: 2.1-18.03, P <0.001) and body When cEVR patients were clearly exclusively ALP prior to therapy <75 U / L remained the only predictor (OR: 8.27, 95% CI: 2.22-30.84, P <0.005) of relapse. CONCLUSION: Lower levels of ALP prior to, during and after therapy seem to be associated with a higher risk of relapse in CHC patients with ETR.
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